Provider Demographics
NPI:1538373808
Name:KNOX, NOREEN GAY CIUDADANO
Entity type:Individual
Prefix:MRS
First Name:NOREEN GAY
Middle Name:CIUDADANO
Last Name:KNOX
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:NOREEN GAY
Other - Middle Name:DULALAS
Other - Last Name:CIUDADANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5595 WALNUT BLOSSOM DR
Mailing Address - Street 2:APT 18
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-2283
Mailing Address - Country:US
Mailing Address - Phone:408-439-4253
Mailing Address - Fax:
Practice Address - Street 1:39022 PRESIDIO WAY
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1221
Practice Address - Country:US
Practice Address - Phone:510-792-3743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33306225100000X
NY027658225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist